Chikasue Tomonori, Sumi Akiko, Tanoue Shuichi, Abe Toshi, Tominaga Masaki, Fukuoka Junya, Fujimoto Kiminori
Department of Radiology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.
Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
Radiol Case Rep. 2022 May 9;17(7):2448-2452. doi: 10.1016/j.radcr.2022.03.108. eCollection 2022 Jul.
We encountered a case of HTLV-1-associated bronchioloalveolar disorder (HABA) that was difficult to distinguish from fibrotic chronic hypersensitivity pneumonitis (CHP). Chest thin-section computed tomography (CT) showed diffuse micronodules and revealed peribronchovascular and perilobular distribution. Further, thickening of the interlobular septa, areas of ground-glass attenuation, traction bronchiectasis/bronchiolectasis, and air trapping were observed. Based on these findings, diseases that cause lymphatic tract abnormalities and fibrotic CHP were considered differential diseases. A surgical lung biopsy was performed, and an HTLV-1 antibody was detected using the Western blot analysis of bronchoalveolar lavage fluid. The final diagnosis of HABA was made through a multidisciplinary discussion.
我们遇到一例难以与纤维化慢性过敏性肺炎（CHP）相鉴别的人嗜T淋巴细胞病毒1型（HTLV-1）相关细支气管肺泡疾病（HABA）。胸部薄层计算机断层扫描（CT）显示弥漫性微小结节，并呈现支气管血管周围和小叶周围分布。此外，还观察到小叶间隔增厚、磨玻璃样衰减区域、牵拉性支气管扩张/细支气管扩张以及空气潴留。基于这些发现，导致淋巴管异常的疾病和纤维化CHP被视为鉴别诊断疾病。进行了外科肺活检，并通过支气管肺泡灌洗液的蛋白质印迹分析检测到HTLV-1抗体。通过多学科讨论做出了HABA的最终诊断。
